Assessing the Impact of Energy and Fuel Poverty on Health: A European Scoping Review

BACKGROUND: The burden of energy and fuel poverty (EFP) in Europe is increasing in the face of the cost-of-living crisis, Russian invasion of Ukraine, COVID-19 pandemic, and climate emergency. While the health impacts of EFP are often the driving reason for addressing it, EFP's association with health is poorly delineated. This review aims to scope the evidence of EFP's association with health in Europe. METHODS: A scoping review based on Arksey and O'Malley's framework was conducted using search terms relevant to EFP, health, and Europe. Five databases were searched, in addition to hand searching. Review selection was performed by two independent reviewers and articles were thematically analysed. RESULTS: Thirty-five articles published between January 2000 and March 2022 were included. The literature varied in definitions and measurements of EFP, and in the health indicators examined. The review revealed a negative association between EFP and health, specifically, general unspecified poor health (9 articles), excess winter mortality (3 articles), communicable disease (3 articles), non-communicable diseases (11 articles), mental health (15 articles), and wellbeing (11 articles). While women were reported to be at higher risk of EFP than men, children and older adults were identified as particularly vulnerable to EFP's adverse health repercussions. CONCLUSIONS: This scoping review illustrates a significant and complex association between EFP and various domains of health. Though heterogeneity across research makes it difficult to compare findings, our review supports the use of health as a justification to address EFP and urges public health to be more involved in EFP mitigation. KEY MESSAGES: • This scoping review revealed a clear association between EFP and various domains of health, including mental (e.g., anxiety and depression) and physical health (e.g., cardiovascular disease and flu). • We recommend health systems, health professionals, and public health broadly as a field be more involved in working to confront EFP.